Romer: Healthcare and insurance costs can be very different things (column)

Half of Coloradans say it has become harder for them to afford health care and this is consistent across key demographic groups throughout the state, regardless of race or income, based on a study by the Kaiser Family Foundation.

This is especially true in the mountain region. Our access to health care in Eagle County is unrivaled for a community our size; however, our health insurance premium prices are climbing at a much faster rate than our actual health care prices.

To fully leverage consumer power on health care prices, consumers must have an expanded role in directly paying for their care. Consumers must also understand that health insurance isn’t health care. We first must create an environment where consumers care about prices and receive benefit from seeking value. But is it even realistic to suggest that people could shop for medical care and seek value, as Americans do for virtually every other good and service?

Some medical care, including emergency care, obviously does not lend itself to price consideration. But emergency care represents only 6 percent of health care expenditures.

“The government, insurance companies, and hospitals seem to be stuck in a blame game — pointing fingers at each other, while partisan politics gets in the way of getting anything accomplished, resulting in increased health insurance costs for our community and fewer businesses being able to offer health benefits to employees.”

One Valley Health Care Program

Vail Valley Partnership created the One Valley Health Care Program because health insurance isn’t health care, and our system of dependence on a limited group of insurance providers in Eagle County is broken. The program is not insurance; instead, we partnered with Sedera Health to leverage a medical cost-sharing model that challenges the insurance status quo in order to meaningfully address consumer costs. Through an innovative layering of health care services, we enable individuals and family’s access to high quality healthcare that is affordable, flexible and effective.

In addition to sharing medical expenses, our partnership with Sedera provides access to valuable counseling, medical bill negotiation, telemedicine, expert second opinions and personal member adviser services for all members.

Mitigating Harmful impact

When people have a reason to shop for value the cost of care comes down without harmful impact on health. For example, a study in Mach of 2015 found that when paired with health savings accounts, spending by those with high-deductible health plans decreased at least 15 percent annually. More than one-third of the savings by enrollees in such coverage reflected value-based decision-making by consumers. Cheaper, limited mandate, high deductible coverage; markedly expanded HSAs; targeted tax incentives to expand their use are key to reducing medical care prices.

Majorities of Coloradans say lowering the amount individuals pay for health care is at least “very important” for the state government to work on; about a quarter each choose health care costs as the “most important issue” for the Colorado state government.

We agree; government needs to be part of the solution. But the government, insurance companies and hospitals seem to be stuck in a blame game — pointing fingers at each other, while partisan politics gets in the way of getting anything accomplished, resulting in increased health insurance costs for our community and fewer businesses being able to offer health benefits to employees.

The individual mandate goes away in 2019, making it increasingly likely people will choose to go without health care. Health care isn’t health insurance, and the One Valley Health Care Program isn’t health insurance. It is, however, an option to help pass meaningful health care savings on to our local population. It hasn’t been easy, but we must be willing to work together toward innovative solutions such as this one.

Cost-sharing programs combined with preventative care programs such as the One Valley Health Care Program is a creative solution to allow our members to pay for their health care needs without spending large amounts on health insurance.

The graduates of Vail Mountain School’s class of 2019 will be off to far-flung destinations next fall, set to enter college in one of 16 different states or explore the world on a gap year. One grad is even attending college in Canada.